Cross-over after failure of IL-2 or IFNalpha2a is poorly efficient in metastatic renal cell carcinoma, especially when progression has been clearly documented.
Forty-three patients with nonmetastatic inflammatory breast carcinoma have been treated by initial doxo-rubicin, 5-fluorouracil, and cyclophosphamide (FAC) combination chemotherapy. After three chemotherapy cycles, responding patients underwent surgery. Chemotherapy was then completed for nine cycles of FAC followed by locoregional radiation therapy. All patients received tamoxifen 40 mg/day for 1 year from the time of diagnosis. Thirty-eight patients (88%) had a clinical response to chemotherapy and underwent surgery. On histologic examination 17 patients had a residual tumor mass less than 1 cm diameter or a complete tumor disappearance; lymph nodes dissection was negative in 15 patients. With a median follow-up of 48 months, the predicted 5-year disease-free survival (DFS) is 48% (median DFS, 46 months). Analysis of prognosis factors shows that age, menopausal status, and histologic grade have no predictive value. The DFS and overall survival were significantly improved by the presence of hormonal receptors and a low number of positive lymph nodes (<4) at surgery. The most significant prognosis factor was the residual tumor mass after initial chemotherapy with an 80% predicted 5-year DFS for the responding patients versus 30% for the no responding patients (P < 0.001). Cancer 65:851-855, 1990. ETWEEN 2% and 5% of breast cancers are inflam-B matory carcinomas. Their prognosis is especially poor. Clinical signs of inflammatory breast carcinoma include elevation of skin temperature, pain, erythema, and edema with dimpling. An tumor mass is rarely palpable. In the PEV2 type, acute inflammatory carcinoma involves more than one third of the breast, whereas in PEV3 type the acute process involves the whole breast. Subcutaneous lymphatic vessels are often invaded by the tumor as demonstrated at skin biopsy,2 but histopatho-logic changes of the skin are not pathogn~monic.~ Prognosis is a major concern. Most cases experience early metastatic dissemination in the first 2 years after Disease-free survival (DFS) rates after 5 years are below lo%, after surgery, radiation therapy, or both.'-' I Initial multiple drug regimens have increased DFS and 5-year survival rates to about 40%."-ls This study reports the results of a treatment strategy for inflammatory breast cancer. Initial chemotherapy in
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.